{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T09:30:34Z","timestamp":1761989434905,"version":"3.37.3"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,5,14]],"date-time":"2020-05-14T00:00:00Z","timestamp":1589414400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The 2014 Bethesda System (TBS 2014) guidelines for reporting cervical cytology revised the age for reporting benign endometrial cells (BECs) from 40 years or older to age 45 years or older. We evaluated this change and further investigated if extending the reporting age to 50 years or older may be acceptable.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We reviewed cases with BECs reported on Papanicolaou tests in women age 40 years or older and 45 years or older before and after implementation of TBS 2014. Follow-up endometrial biopsy\/curettage results were categorized as benign, endometrial hyperplasia with or without atypia, or malignant. Hyperplasia and malignant follow-up were considered clinically significant. Clinical data were documented. Results were compared for women age 40 to 44, 45 to 49, and 50 years or older.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Follow-up in 15 (100%) women age 40 to 44 years was benign. In women age 45 to 49 years, 61 (96.8%) had benign follow-up, one (1.6%) had atypical hyperplasia, and one (1.6%) had malignant follow-up. In women age 50 years or older, 57 (86.5%) had benign follow-up, four (6%) had malignant follow-up, and seven (7.5%) had atypical or nonatypical hyperplasia. There was a significant difference in follow-up between the age groups of 40 to 49 and 50 or older (P = .023).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We conclude that the TBS 2014 revision was justified. Our data suggest that age 50 years or older rather than age 45 years or older may be an acceptable cutoff for reporting BECs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajcp\/aqaa041","type":"journal-article","created":{"date-parts":[[2020,3,6]],"date-time":"2020-03-06T12:19:58Z","timestamp":1583497198000},"page":"381-386","source":"Crossref","is-referenced-by-count":3,"title":["Reporting of Benign Endometrial Cells in Papanicolaou Tests"],"prefix":"10.1093","volume":"154","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3197-9130","authenticated-orcid":false,"given":"Andrea","family":"Hernandez","sequence":"first","affiliation":[{"name":"Department of Pathology , NYU Langone Health, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Schatz-Siemers","sequence":"additional","affiliation":[{"name":"Department of Pathology , NYU Langone Health, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5542-2994","authenticated-orcid":false,"given":"Fang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Pathology , NYU Langone Health, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamar C","family":"Brandler","sequence":"additional","affiliation":[{"name":"Department of Pathology , NYU Langone Health, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raquel","family":"Negron","sequence":"additional","affiliation":[{"name":"Department of Pathology , NYU Langone Health, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lopa","family":"Modi","sequence":"additional","affiliation":[{"name":"Department of Pathology , NYU Langone Health, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul A","family":"Elgert","sequence":"additional","affiliation":[{"name":"Department of Pathology, NYU Robert I. Grossman School of Medicine, NYC Health + Hospitals, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aylin","family":"Simsir","sequence":"additional","affiliation":[{"name":"Department of Pathology , NYU Langone Health, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,5,14]]},"reference":[{"key":"2020080503203544900_CIT0001","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1002\/dc.23727","article-title":"Endometrial cells on Pap tests: ideal reporting is more complex than just finding the right age","volume":"45","author":"Fischer","year":"2017","journal-title":"Diagn Cytopathol."},{"key":"2020080503203544900_CIT0002","first-page":"427","article-title":"The presence of endometrial cells in cervical smears in relation to the day of the menstrual cycle and the method of contraception","volume":"31","author":"Vooijs","year":"1987","journal-title":"Acta Cytol."},{"key":"2020080503203544900_CIT0003","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1007\/978-1-4684-0201-8","volume-title":"The Bethesda System for Reporting Cervical and Vaginal Cytologic Diagnosis.","author":"Kurman","year":"1994"},{"key":"2020080503203544900_CIT0004","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1007\/978-1-4612-2042-8","volume-title":"The Bethesda System for Reporting Cervical Cytology.","author":"Solomon","year":"2004"},{"key":"2020080503203544900_CIT0005","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1007\/978-3-319-11074-5","volume-title":"The Bethesda System for Reporting Cervical Cytology.","author":"Nayar","year":"2015"},{"key":"2020080503203544900_CIT0006","first-page":"242","article-title":"Significance of normal endometrial cells detected by cervical cytology","volume":"71","author":"Cherkis","year":"1988","journal-title":"Obstet Gynecol."},{"key":"2020080503203544900_CIT0007","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1006\/gyno.1999.5435","article-title":"Reporting normal endometrial cells in Pap smears: an outcome appraisal","volume":"74","author":"Gomez-Fernandez","year":"1999","journal-title":"Gynecol Oncol."},{"key":"2020080503203544900_CIT0008","doi-asserted-by":"crossref","first-page":"2256","DOI":"10.1002\/1097-0142(19851101)56:9<2256::AID-CNCR2820560920>3.0.CO;2-F","article-title":"The validity of Pap smear parameters as predictors of endometrial pathology in menopausal women","volume":"56","author":"Zucker","year":"1985","journal-title":"Cancer."},{"key":"2020080503203544900_CIT0009","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.ygyno.2007.05.036","article-title":"The Bethesda System 2001 recommendation for reporting of benign appearing endometrial cells in Pap tests of women age 40 years and older leads to unwarranted surveillance when followed without clinical qualifiers","volume":"107","author":"Aslan","year":"2007","journal-title":"Gynecol Oncol."},{"key":"2020080503203544900_CIT0010","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1159\/000325712","article-title":"Reporting endometrial cells in Papanicolaou smears of women age 40 and older: a qualifying educational note could prevent unnecessary follow-up biopsy","volume":"51","author":"El-Fakharany","year":"2007","journal-title":"Acta Cytol."},{"key":"2020080503203544900_CIT0011","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1309\/LJRD8JGJ7E5ERBUW","article-title":"Reporting endometrial cells in women 40 years and older: assessing the clinical usefulness of Bethesda 2001","volume":"123","author":"Simsir","year":"2005","journal-title":"Am J Clin Pathol."},{"key":"2020080503203544900_CIT0012","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1309\/AJCP07DCKKZFKSDL","article-title":"Histologic follow-up in patients with Papanicolaou test findings of endometrial cells: results from a large academic women\u2019s hospital laboratory","volume":"138","author":"Li","year":"2012","journal-title":"Am J Clin Pathol."},{"key":"2020080503203544900_CIT0013","first-page":"1","article-title":"Cervical and vaginal cytology","volume-title":"Cytology: Diagnostic Principles and Clinical Correlates.","author":"Barbara","year":"2014","edition":"4th ed"},{"key":"2020080503203544900_CIT0014","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1159\/000473694","article-title":"Evaluating the age cutoff criterion for reporting benign-appearing endometrial cells in routine Pap tests: an 8-year retrospective review","volume":"61","author":"Grada","year":"2017","journal-title":"Acta Cytol."},{"key":"2020080503203544900_CIT0015","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1093\/AJCP\/AQX075","article-title":"Negative predictive value and significance of benign-appearing endometrial cells in Papanicolaou tests","volume":"148","author":"Yu","year":"2017","journal-title":"Am J Clin Pathol."},{"key":"2020080503203544900_CIT0016","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.jasc.2018.09.002","article-title":"Age cutoff for reporting of benign-appearing endometrial cells in Papanicolaou specimens; should it be raised? A 10-year retrospective study from a large county hospital","volume":"8","author":"Hinson","year":"2019","journal-title":"J Am Soc Cytopathol."},{"key":"2020080503203544900_CIT0017","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1111\/cyt.12280","article-title":"Age cut-off for reporting endometrial cells on a Papanicolaou test: 50 years may be more appropriate than 45 years","volume":"27","author":"Weiss","year":"2016","journal-title":"Cytopathology."},{"key":"2020080503203544900_CIT0018","doi-asserted-by":"crossref","first-page":"22","DOI":"10.4103\/cytojournal.cytojournal_16_17","article-title":"Significance of finding benign endometrial cells in women 40-45 versus 46 years or older on Papanicolaou tests and histologic follow-up","volume":"14","author":"Colletti","year":"2017","journal-title":"Cytojournal."},{"key":"2020080503203544900_CIT0019","first-page":"298","article-title":"The clinical significance of endometrial cells detected on Pap testing: the impact of revisions to the 3rd edition of the Bethesda system for reporting cervical cytology","volume":"47","author":"Morikawa","year":"2017","journal-title":"Ann Clin Lab Sci."},{"key":"2020080503203544900_CIT0020","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1097\/LGT.0b013e318287d329","article-title":"2012 ASCCP consensus guidelines conference: 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors","volume":"17","author":"Massad","year":"2013","journal-title":"J Low Genit Tract Dis."},{"key":"2020080503203544900_CIT0021","first-page":"795","article-title":"Significance of benign endometrial cells in Pap smears from postmenopausal women","volume":"46","author":"Wu","year":"2001","journal-title":"J Reprod Med."},{"key":"2020080503203544900_CIT0022","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1159\/000381326","article-title":"Normal-appearing endometrial cells in Pap tests of women aged forty years or older and cytohistological correlates","volume":"59","author":"Izadi-Mood","year":"2015","journal-title":"Acta Cytol."},{"key":"2020080503203544900_CIT0023","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.5858\/arpa.2018-0603-CP","article-title":"Bethesda 2014 implementation and human papillomavirus primary screening: practices of laboratories participating in the College of American Pathologists PAP Education Program","volume":"143","author":"Davey","year":"2019","journal-title":"Arch Pathol Lab Med."}],"container-title":["American Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ajcp\/article-pdf\/154\/3\/381\/33566464\/aqaa041.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ajcp\/article-pdf\/154\/3\/381\/33566464\/aqaa041.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,8,5]],"date-time":"2020-08-05T07:20:54Z","timestamp":1596612054000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajcp\/article\/154\/3\/381\/5836906"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,14]]},"references-count":23,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2020,5,14]]},"published-print":{"date-parts":[[2020,8,5]]}},"URL":"https:\/\/doi.org\/10.1093\/ajcp\/aqaa041","relation":{},"ISSN":["0002-9173","1943-7722"],"issn-type":[{"type":"print","value":"0002-9173"},{"type":"electronic","value":"1943-7722"}],"subject":[],"published-other":{"date-parts":[[2020,9]]},"published":{"date-parts":[[2020,5,14]]}}}